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Subiza-Pérez M, García-Baquero G, Fernández-Somoano A, Guxens M, González L, Tardón A, Dadvand P, Estarlich M, de Castro M, McEachan RRC, Ibarluzea J, Lertxundi N. Residential green and blue spaces and working memory in children aged 6-12 years old. Results from the INMA cohort. Health Place 2023; 84:103136. [PMID: 37871446 DOI: 10.1016/j.healthplace.2023.103136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 10/02/2023] [Accepted: 10/03/2023] [Indexed: 10/25/2023]
Abstract
Availability of green and blue spaces in the area of residence has been related to various health outcomes during childhood, including neurodevelopment. Some studies have shown that children living in greener and/or bluer areas score better on cognitive tasks although the evidence is inconsistent. These protective effects are hypothesized to occur in part through reductions in air pollution exposure and odds of attention-deficit/hyperactivity disorder (ADHD). This study analysed the effects of residential green and blue spaces on working memory of children in the Spanish INfancia y Medio Ambiente (INMA) birth cohort and the potential joint mediating role of air pollution and ADHD. The study samples were composed of 1738 six-to eight-year-olds (M = 7.53, SD = 0.68, 49% female) and 1449 ten-to twelve-year-olds (M = 11.18, SD = 0.69, 50% female) living in Asturias, Gipuzkoa, Sabadell or Valencia, Spain. Individual Normalized Difference Vegetation Index (NDVI) values in 100-, 300- and 500-m buffers and availability of green and blue spaces >5000 m2 in 300-m buffers were calculated using Geographic Information Systems software. Individual NO2 values for the home environment were estimated using ESCAPE's land use regression models. ADHD diagnosis was reported by participants' parents via a questionnaire. Working memory was measured with numbers and colours (in the younger group only) N-back tests (2- and 3-back d'). Mixed-effects models informed of the beneficial effects of NDVI in a 300-m buffer on numerical working memory in the younger sample although the results were not consistent for all d' scores considered and failed to detect significant effects through the candidate mediators. Availability of major blue spaces did not predict working memory performance. Provision of green spaces may play a role in children's working memory but further research is required.
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Affiliation(s)
- Mikel Subiza-Pérez
- Department of Clinical and Health Psychology and Research Methods, University of the Basque Country UPV/EHU, Avenida Tolosa 70, 20018, Donostia-San Sebastián, Spain; Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Duckworth Lane, BD9 6RJ, Bradford, UK; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, c/ Monforte de Lemos 3-5, Madrid, 280, Spain; Biogipuzkoa Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain s/n, 20014, Donostia- San Sebastián, Spain.
| | - Gonzalo García-Baquero
- Biogipuzkoa Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain s/n, 20014, Donostia- San Sebastián, Spain; Faculty of Biology, University of Salamanca, Avda Licenciado Méndez Nieto s/n, 37007, Salamanca, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33001, Oviedo, Spain.
| | - Ana Fernández-Somoano
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, c/ Monforte de Lemos 3-5, Madrid, 280, Spain; Unidad de Epidemiología Molecular Del Cáncer, Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Departamento de Medicina, Universidad de Oviedo, 33006, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33001, Oviedo, Spain.
| | - Mónica Guxens
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, c/ Monforte de Lemos 3-5, Madrid, 280, Spain; ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands.
| | - Llucia González
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, c/ Monforte de Lemos 3-5, Madrid, 280, Spain; University of Valencia, Avda Menéndez Pelayo, 19, 46010, Valencia, Spain; Joint Research Unit in Epidemiology, Environment and Health, FISABIO-University of Valencia-Universitat Jaume I, Valencia, Spain.
| | - Adonina Tardón
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, c/ Monforte de Lemos 3-5, Madrid, 280, Spain; Unidad de Epidemiología Molecular Del Cáncer, Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Departamento de Medicina, Universidad de Oviedo, 33006, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33001, Oviedo, Spain.
| | - Payam Dadvand
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, c/ Monforte de Lemos 3-5, Madrid, 280, Spain; ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain.
| | - Marisa Estarlich
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, c/ Monforte de Lemos 3-5, Madrid, 280, Spain; University of Valencia, Avda Menéndez Pelayo, 19, 46010, Valencia, Spain; Joint Research Unit in Epidemiology, Environment and Health, FISABIO-University of Valencia-Universitat Jaume I, Valencia, Spain.
| | - Montserrat de Castro
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, c/ Monforte de Lemos 3-5, Madrid, 280, Spain; ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain.
| | - Rosemary R C McEachan
- Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Duckworth Lane, BD9 6RJ, Bradford, UK.
| | - Jesús Ibarluzea
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, c/ Monforte de Lemos 3-5, Madrid, 280, Spain; Biogipuzkoa Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain s/n, 20014, Donostia- San Sebastián, Spain; Ministry of Health of the Basque Government, 20013, Donostia-San Sebastián, Spain; Faculty of Psychology, University of the Basque Country UPV/EHU, Avenida Tolosa 70, 20018, Donostia-San Sebastián, Spain.
| | - Nerea Lertxundi
- Department of Clinical and Health Psychology and Research Methods, University of the Basque Country UPV/EHU, Avenida Tolosa 70, 20018, Donostia-San Sebastián, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, c/ Monforte de Lemos 3-5, Madrid, 280, Spain; Biogipuzkoa Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain s/n, 20014, Donostia- San Sebastián, Spain.
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2
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Datin-Dorrière V, Borst G, Guillois B, Cachia A, Poirel N. The forest, the trees, and the leaves in preterm children: the impact of prematurity on a visual search task containing three-level hierarchical stimuli. Eur Child Adolesc Psychiatry 2021; 30:253-260. [PMID: 32193647 DOI: 10.1007/s00787-020-01510-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 03/10/2020] [Indexed: 11/25/2022]
Abstract
Very preterm (VPT; < 33 gestational weeks) children are at risk of developing visuospatial deficits, including local/global attention deficits. They are also more likely to develop poorer inhibitory control. Here, we investigated, using the same stimuli, the potential local/global attention and inhibitory control deficits of VPT children using three levels compound stimuli (global, intermediate, and local levels), more ecological than the ones used in a classic global/local task (Navon task). We compared the results from 22 VPT children to those of a control group of 21 children to investigate (1) how VPT children processed compound stimuli with three-level information and (2) how inhibitory control in a visual task differs between VPT and control children. The results revealed that VPT children had no difficulty processing information presented at the local level. By contrast, VPT children were impaired when considering the intermediate and global levels of processing in comparison to control children. Finally, a reduced efficiency in VPT children in inhibiting visual distractors was evidenced for the conditions with a larger number of distractors. These results are discussed in terms of neurodevelopmental disorders of both dorsal stream (global visual processing) and prefrontal regions (inhibitory control) in VPT children. Given the central role of visuospatial and inhibitory control in day-to-day situations, the present results provide important clues for pedagogical implications regarding the organization of visual information presented to VPT children.
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Affiliation(s)
- Valérie Datin-Dorrière
- Université de Paris, LaPsyDÉ, CNRS, 75005, Paris, France.,Service de Néonatologie, CHU Caen, Caen, France.,GIP Cyceron, Caen, France
| | - Grégoire Borst
- Université de Paris, LaPsyDÉ, CNRS, 75005, Paris, France.,Institut Universitaire de France (IUF), Paris, France
| | | | - Arnaud Cachia
- Université de Paris, LaPsyDÉ, CNRS, 75005, Paris, France.,Institut Universitaire de France (IUF), Paris, France
| | - Nicolas Poirel
- Université de Paris, LaPsyDÉ, CNRS, 75005, Paris, France. .,Institut Universitaire de France (IUF), Paris, France. .,GIP Cyceron, Caen, France.
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3
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Fernandez-Baizan C, Caunedo-Jimenez M, Martinez JA, Arias JL, Mendez M, Solis G. Development of visuospatial memory in preterm infants: A new paradigm to assess short-term and working memory. Child Neuropsychol 2020; 27:296-316. [PMID: 33191857 DOI: 10.1080/09297049.2020.1847264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Preterm infants have a higher risk of showing visuospatial memory impairment, the function that allows to encode and remember visual and spatial information. It has been studied in late childhood in preterm children. Studies on visuospatial memory throughout the first 2 years of life are still scarce. Behavior, temperament, and overall cognition could be altered in preterm children affecting memory performance. Therefore, the main aim of this study was to evaluate short-term and visuospatial working memory performance in a preterm sample followed longitudinally at 12, 15, 18, and 22 months (N = 15), and compare their performance with that of full-term children (N = 65). The secondary aim was to analyze the course of mnesic development in preterm infants and relate their memory performance to other cognitive abilities and behavioral tendencies. Assessment included previously published tasks and an experimental paradigm. Results showed that preterm children scored lower than full-term children on visuospatial short-term and working memory at 12 and 22 months of age, although these results varied depending on the memory test used. Preterm children's memory results showed that these skills improve in this population between the first and second year of life. Finally, memory performance was directly associated with the level of cognitive development and the presence of proactive behaviors, while being inversely correlated with the presence of disruptive behaviors and a difficult temperamental style. These preliminary findings suggest that it is possible to detect visuospatial memory difficulties in the preterm population before the age of two.
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Affiliation(s)
- C Fernandez-Baizan
- Neuroscience Institute of Principado de Asturias (INEUROPA), University of Oviedo, Oviedo, Spain.,Department of Psychology, University of Oviedo, Oviedo, Spain
| | - M Caunedo-Jimenez
- Pediatric Clinic Area, Neonatology, University Central Hospital of Asturias, Oviedo, Spain
| | - J A Martinez
- Neuroscience Institute of Principado de Asturias (INEUROPA), University of Oviedo, Oviedo, Spain.,Department of Electronic Technology, University of Oviedo, Gijón, Spain
| | - J L Arias
- Neuroscience Institute of Principado de Asturias (INEUROPA), University of Oviedo, Oviedo, Spain.,Department of Psychology, University of Oviedo, Oviedo, Spain
| | - M Mendez
- Neuroscience Institute of Principado de Asturias (INEUROPA), University of Oviedo, Oviedo, Spain.,Department of Psychology, University of Oviedo, Oviedo, Spain
| | - G Solis
- Neuroscience Institute of Principado de Asturias (INEUROPA), University of Oviedo, Oviedo, Spain.,Pediatric Clinic Area, Neonatology, University Central Hospital of Asturias, Oviedo, Spain
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4
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Kroll J, Karolis V, Brittain PJ, Tseng CEJ, Froudist-Walsh S, Murray RM, Nosarti C. Systematic assessment of perinatal and socio-demographic factors associated with IQ from childhood to adult life following very preterm birth. INTELLIGENCE 2019. [DOI: 10.1016/j.intell.2019.101401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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5
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Sato J, Mossad SI, Wong SM, Hunt BAE, Dunkley BT, Urbain C, Taylor MJ. Spectral slowing is associated with working memory performance in children born very preterm. Sci Rep 2019; 9:15757. [PMID: 31673006 PMCID: PMC6823447 DOI: 10.1038/s41598-019-52219-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 10/13/2019] [Indexed: 11/20/2022] Open
Abstract
Children born very preterm (VPT) often demonstrate selective difficulties in working memory (WM), which may underlie academic difficulties observed in this population. Despite this, few studies have investigated the functional networks underlying WM in young children born VPT, a period when cognitive deficits become apparent. Using magnetoencephalography, we examined the networks underlying the maintenance of visual information in 6-year-old VPT (n = 15) and full-term (FT; n = 20) children. Although task performance was similar, VPT children engaged different oscillatory mechanisms during WM maintenance. Within the FT group, we observed higher mean whole-brain connectivity in the alpha-band during the retention (i.e. maintenance) interval associated with correct compared to incorrect responses. VPT children showed reduced whole-brain alpha synchrony, and a different network organization with fewer connections. In the theta-band, VPT children demonstrated a slight increase in whole-brain connectivity during WM maintenance, and engaged similar network hubs as FT children in the alpha-band, including the left dorsolateral prefrontal cortex and superior temporal gyrus. These findings suggest that VPT children rely on the theta-band to support similar task performance. Altered oscillatory mechanisms may reflect a less mature pattern of functional recruitment underlying WM in VPT children, which may affect the processing in complex ecological situations.
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Affiliation(s)
- Julie Sato
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada. .,Department of Psychology, University of Toronto, Toronto, Canada. .,Neuroscience & Mental Health Program, The Hospital for Sick Children Research Institute, Toronto, Canada.
| | - Sarah I Mossad
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada.,Department of Psychology, University of Toronto, Toronto, Canada.,Neuroscience & Mental Health Program, The Hospital for Sick Children Research Institute, Toronto, Canada
| | - Simeon M Wong
- Neuroscience & Mental Health Program, The Hospital for Sick Children Research Institute, Toronto, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Benjamin A E Hunt
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada.,Neuroscience & Mental Health Program, The Hospital for Sick Children Research Institute, Toronto, Canada
| | - Benjamin T Dunkley
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada.,Neuroscience & Mental Health Program, The Hospital for Sick Children Research Institute, Toronto, Canada.,Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Charline Urbain
- UR2NF - Neuropsychology and Functional Neuroimaging Research Group at Center for Research in Cognition and Neurosciences (CRCN) and ULB Neurosciences Institute (UNI), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Margot J Taylor
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada.,Department of Psychology, University of Toronto, Toronto, Canada.,Neuroscience & Mental Health Program, The Hospital for Sick Children Research Institute, Toronto, Canada.,Department of Medical Imaging, University of Toronto, Toronto, Canada
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6
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Tokariev M, Vuontela V, Lönnberg P, Lano A, Perkola J, Wolford E, Andersson S, Metsäranta M, Carlson S. Altered working memory-related brain responses and white matter microstructure in extremely preterm-born children at school age. Brain Cogn 2019; 136:103615. [PMID: 31563082 DOI: 10.1016/j.bandc.2019.103615] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/10/2019] [Accepted: 09/13/2019] [Indexed: 11/28/2022]
Abstract
Preterm birth poses a risk for neurocognitive and behavioral development. Preterm children, who have not been diagnosed with neurological or cognitive deficits, enter normal schools and are expected to succeed as their term-born peers. Here we tested the hypotheses that despite an uneventful development after preterm birth, these children might exhibit subtle abnormalities in brain function and white-matter microstructure at school-age. We recruited 7.5-year-old children born extremely prematurely (<28 weeks' gestation), and age- and gender-matched term-born controls (≥37 weeks' gestation). We applied fMRI during working-memory (WM) tasks, and investigated white-matter microstructure with diffusion tensor imaging. Compared with controls, preterm-born children performed WM tasks less accurately, had reduced activation in several right prefrontal areas, and weaker deactivation of right temporal lobe areas. The weaker prefrontal activation correlated with poorer WM performance. Preterm-born children had higher fractional anisotropy (FA) and lower diffusivity than controls in several white-matter areas, and in the posterior cerebellum, the higher FA associated with poorer visuospatial test scores. In controls, higher FA and lower diffusivity correlated with faster WM performance. Together these findings demonstrate weaker WM-related brain activations and altered white matter microstructure in children born extremely preterm, who had normal global cognitive ability.
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Affiliation(s)
- Maksym Tokariev
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; Department of Physiology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Virve Vuontela
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; Department of Physiology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Piia Lönnberg
- Department of Child Neurology, Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Aulikki Lano
- Department of Child Neurology, Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jaana Perkola
- Department of Clinical Neurophysiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Elina Wolford
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Sture Andersson
- Department of Pediatrics, Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Marjo Metsäranta
- Department of Pediatrics, Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Synnöve Carlson
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; Department of Physiology, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Advanced Magnetic Imaging Centre, Aalto University School of Science, Espoo, Finland.
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7
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Everts R, Schöne CG, Mürner-Lavanchy I, Steinlin M. Development of executive functions from childhood to adolescence in very preterm-born individuals - A longitudinal study. Early Hum Dev 2019; 129:45-51. [PMID: 30639465 DOI: 10.1016/j.earlhumdev.2018.12.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 12/14/2018] [Accepted: 12/17/2018] [Indexed: 11/29/2022]
Abstract
Preterm-born individuals are at risk for poorer executive functions. Longitudinal studies investigating whether preterm-born individuals present persistent cognitive deficits, or a transient delay of development are scarce. We assessed developmental trajectories of executive functions (inhibition, working memory, cognitive flexibility) in 29 very preterm-born individuals (<32 weeks' gestation) and 25 term-born controls longitudinally over two time points, namely in childhood (7-12 years of age, TP1) and adolescence (13-16 years of age, TP2). Individual changes in executive functions were examined using relative difference scores (TP2 - TP1) / TP1). There was a significantly stronger improvement of inhibition (U = 477, p = .024) and cognitive flexibility (U = 312, p = .029) between childhood and adolescence in very preterm-born individuals than in term-born controls. Preterm-born individuals improved their performance in the domain of cognitive flexibility significantly more often (76%) between childhood and adolescence than controls (31%, χ2 = 8.6, p = .003). Controls worsened significantly more often (36%) in the domain of inhibition than the preterm group (14%, χ2 = 4.8, p = .028). Results indicate that healthy preterm-born individuals show prolonged development of executive functions throughout childhood up into adolescence.
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Affiliation(s)
- Regula Everts
- Division of Neuropediatrics, Development and Rehabilitation, Children's University Hospital, Inselspital, Bern University Hospital, University of Bern, Switzerland.
| | - Corina G Schöne
- Institute of Psychology, University of Bern, Switzerland; Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Ines Mürner-Lavanchy
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Maja Steinlin
- Division of Neuropediatrics, Development and Rehabilitation, Children's University Hospital, Inselspital, Bern University Hospital, University of Bern, Switzerland
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8
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Hodel AS. Rapid Infant Prefrontal Cortex Development and Sensitivity to Early Environmental Experience. DEVELOPMENTAL REVIEW 2018; 48:113-144. [PMID: 30270962 PMCID: PMC6157748 DOI: 10.1016/j.dr.2018.02.003] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Over the last fifteen years, the emerging field of developmental cognitive neuroscience has described the relatively late development of prefrontal cortex in children and the relation between gradual structural changes and children's protracted development of prefrontal-dependent skills. Widespread recognition by the broader scientific community of the extended development of prefrontal cortex has led to the overwhelming perception of prefrontal cortex as a "late developing" region of the brain. However, despite its supposedly protracted development, multiple lines of research have converged to suggest that prefrontal cortex development may be particularly susceptible to individual differences in children's early environments. Recent studies demonstrate that the impacts of early adverse environments on prefrontal cortex are present very early in development: within the first year of life. This review provides a comprehensive overview of new neuroimaging evidence demonstrating that prefrontal cortex should be characterized as a "rapidly developing" region of the brain, discusses the converging impacts of early adversity on prefrontal circuits, and presents potential mechanisms via which adverse environments shape both concurrent and long-term measures of prefrontal cortex development. Given that environmentally-induced disparities are present in prefrontal cortex development within the first year of life, translational work in intervention and/or prevention science should focus on intervening early in development to take advantages of this early period of rapid prefrontal development and heightened plasticity.
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9
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Stålnacke J, Lundequist A, Böhm B, Forssberg H, Smedler AC. A longitudinal model of executive function development from birth through adolescence in children born very or extremely preterm. Child Neuropsychol 2018; 25:318-335. [DOI: 10.1080/09297049.2018.1477928] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
| | - Aiko Lundequist
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Birgitta Böhm
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Hans Forssberg
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
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10
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Leviton A, Joseph RM, Allred EN, O’Shea TM, Taylor HG, Kuban KKC. Antenatal and Neonatal Antecedents of Executive Dysfunctions in Extremely Preterm Children. J Child Neurol 2018; 33:198-208. [PMID: 29322860 PMCID: PMC5807158 DOI: 10.1177/0883073817750499] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
To find out why children born extremely preterm are at heightened risk of executive dysfunctions, the authors assessed 716 children who were 10 years old born extremely preterm whose IQ was ≥ 70. A working memory dysfunction (n = 169), an inhibition dysfunction (n = 360), a switching dysfunction (355), and all 3 (executive dysfunction; n = 107) were defined on the basis of Z-scores ≤ -1 on the Differential Ability Scales-II Working Memory composite, and/or on the NEPSY-II Inhibition-Inhibition and Inhibition-Switching subtests. All risk profiles include an indicator of socioeconomic disadvantage. The risk profile of each of the 3 individual dysfunctions includes an indicator of the newborn's immaturity, and the risk profiles of the inhibition dysfunction and switching dysfunction also include an indicator of inflammation. Only the switching dysfunction was associated with fetal growth restriction. The risk factors for executive dysfunction can be subsumed under the 4 themes of socioeconomic disadvantage, immaturity/vulnerability, inflammation, and fetal growth restriction.
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Affiliation(s)
- Alan Leviton
- Boston Children’s Hospital and Harvard Medical School,
Boston MA, USA
| | | | | | - T. Michael O’Shea
- University of North Carolina School of Medicine, Chapel Hill NC,
USA
| | - H. Gerry Taylor
- Nationwide Children’s Hospital and The Ohio State
University, Columbus, OH, USA
| | - Karl KC Kuban
- Boston Medical Center and Boston University School of Medicine,
Boston, MA, USA
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11
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Gu H, Wang L, Liu L, Luo X, Wang J, Hou F, Nkomola PD, Li J, Liu G, Meng H, Zhang J, Song R. A gradient relationship between low birth weight and IQ: A meta-analysis. Sci Rep 2017; 7:18035. [PMID: 29269836 PMCID: PMC5740123 DOI: 10.1038/s41598-017-18234-9] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 12/08/2017] [Indexed: 01/08/2023] Open
Abstract
Multiple studies have reported that individuals with low birth weights (LBW, <2500 g) have a lower intelligence quotient (IQ) than those with normal birth weights (NBW, ≥2500 g). Based on 57 eligible individual studies including 12,137 participants, we performed a meta-analysis to estimate the association between low birth weight and individuals' IQ scores (IQs). The pooled weight mean difference (WMD) in IQs between NBW and LBW individuals was 10 (95% CI 9.26-11.68). The WMD was stable regardless of age. No publication bias was detected. The mean IQs of the extremely low birth weight (ELBW, <1000 g), very low birth weight (VLBW, 1000-1499 g), moderately low birth weight (MLBW, 1500-2499 g) and NBW individuals were 91, 94, 99 and 104, respectively. Additionally, the WMD in IQs with NBW were 14, 10 and 7 for ELBW, VLBW, and MLBW individuals, respectively. Two studies permitted estimates of the influence of social determinants of health to the discrepancy in IQs, which was 13%. Since IQ is inherited and influenced by environmental factors, parental IQs and other factors contribute to residual confounding of the results. As the conclusion was based on population studies, it may not be applicable to a single individual.
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Affiliation(s)
- Huaiting Gu
- Department of Maternal and Child Health, and MOE (Ministry of Education) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- School of Public Health, Jining Medical College, Jining, 272067, China
| | - Lixia Wang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Lingfei Liu
- Department of Maternal and Child Health, and MOE (Ministry of Education) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiu Luo
- Department of Maternal and Child Health, and MOE (Ministry of Education) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jia Wang
- Department of Maternal and Child Health, and MOE (Ministry of Education) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Fang Hou
- Department of Maternal and Child Health, and MOE (Ministry of Education) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Pauline Denis Nkomola
- Department of Maternal and Child Health, and MOE (Ministry of Education) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jing Li
- School of Public Health, Jining Medical College, Jining, 272067, China
| | - Genyi Liu
- School of Public Health, Jining Medical College, Jining, 272067, China
| | - Heng Meng
- Department of Maternal and Child Health, and MOE (Ministry of Education) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, 29208, USA
| | - Ranran Song
- Department of Maternal and Child Health, and MOE (Ministry of Education) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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12
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Arthursson PMSH, Thompson DK, Spencer-Smith M, Chen J, Silk T, Doyle LW, Anderson PJ. Atypical neuronal activation during a spatial working memory task in 13-year-old very preterm children. Hum Brain Mapp 2017; 38:6172-6184. [PMID: 28940977 DOI: 10.1002/hbm.23820] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 08/22/2017] [Accepted: 09/10/2017] [Indexed: 11/07/2022] Open
Abstract
Children born very preterm (VP; <32 weeks' gestational age) are at risk for unfavorable outcomes in several cognitive domains, including spatial working memory (WM). The underlying neural basis of these cognitive impairments is poorly understood. We investigated differences in neuronal activation during spatial WM using a backward span (BS) task relative to a control (C) task in 45 VP children and 19 term-born controls aged 13 years. VP children showed significantly more activation in the bilateral superior frontal gyrus and significantly less activation in the left parahippocampal gyrus compared with controls. We further explored the distinct contributions of maintenance and manipulation processes of WM using forward span (FS)>C and BS > FS, respectively. There were no significant group differences in neuronal activation for FS > C. However, BS > FS revealed that VP children had significantly greater activation in the left middle frontal gyrus, in the left superior parietal gyrus and right cerebellar tonsil, and significantly less activation in the right precentral and postcentral gyrus and left insula compared with controls. Taken together these results suggest that VP children at 13 years of age show an atypical neuronal activation during spatial WM, specifically related to manipulation of spatial information in WM. It is unclear whether these findings reflect delayed maturation and/or recruitment of alternative neuronal networks as a result of neuroplasticity. Hum Brain Mapp 38:6172-6184, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Pia-Maria S H Arthursson
- Murdoch Childrens Research Institute, Parkville, Victoria, 3052, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, 3052, Australia
| | - Deanne K Thompson
- Murdoch Childrens Research Institute, Parkville, Victoria, 3052, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, 3052, Australia.,Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, 3052, Australia
| | - Megan Spencer-Smith
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria, 3800, Australia
| | - Jian Chen
- Murdoch Childrens Research Institute, Parkville, Victoria, 3052, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, 3052, Australia
| | - Tim Silk
- Murdoch Childrens Research Institute, Parkville, Victoria, 3052, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, 3052, Australia
| | - Lex W Doyle
- Murdoch Childrens Research Institute, Parkville, Victoria, 3052, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, 3052, Australia.,Department of Obstetrics and Gynaecology, The Royal Women's Hospital, University of Melbourne, Parkville, Victoria, 3010, Australia
| | - Peter J Anderson
- Murdoch Childrens Research Institute, Parkville, Victoria, 3052, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, 3052, Australia.,School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria, 3800, Australia
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13
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Lee CSC, Pei J, Andrew G, A Kerns K, Rasmussen C. Effects of working memory training on children born preterm. APPLIED NEUROPSYCHOLOGY-CHILD 2016; 6:281-296. [PMID: 27259472 DOI: 10.1080/21622965.2016.1161513] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Researchers have reported benefits of working memory training in various populations, however, the training gains in preterm population is still inadequately studied. This study aimed to investigate the transfer and lasting effects of an online working memory training program on a group of preterm children aged between 4 and 6 years (mean gestational age = 28.3 weeks; mean birth weight = 1153 grams). Children were asked to perform the Cogmed JM at home for approximately 15 minutes a day, 5 days a week for 5 weeks. Their nontrained working memory and attention were assessed pre-training, post-training, and at 5-week follow-up. Parent ratings on children's executive functions were obtained at the three time points. Results revealed that significant improvements in verbal working memory was emerging in preterm children at 5-week follow-up, while significant gains in visuospatial working memory was found post-training and at 5-week follow-up in age-matched term-born children. These results indicated that working memory training has benefits on preterm children; however, the gains are different from those observed in term-born children. No significant differences in attention and parent-rated EF were found in either group across time. The possible explanations for the training benefits observed in preterm children were discussed.
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Affiliation(s)
- Clara S C Lee
- a Educational Psychology, University of Alberta , Edmonton , Alberta , Canada
| | - Jacqueline Pei
- a Educational Psychology, University of Alberta , Edmonton , Alberta , Canada
| | - Gail Andrew
- b Glenrose Rehabilitation Hospital , Edmonton , Alberta , Canada
| | - Kimberly A Kerns
- c Psychology, University of Victoria , Victoria , British Colombia , Canada
| | - Carmen Rasmussen
- d Glenrose Rehabilitation Hospital, Pediatrics , Edmonton , Alberta , Canada
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14
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Schneider LA, Burns NR, Giles LC, Nettelbeck TJ, Hudson IL, Ridding MC, Pitcher JB. The influence of motor function on processing speed in preterm and term-born children. Child Neuropsychol 2015; 23:300-315. [DOI: 10.1080/09297049.2015.1102215] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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15
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Back SA. Brain Injury in the Preterm Infant: New Horizons for Pathogenesis and Prevention. Pediatr Neurol 2015; 53:185-92. [PMID: 26302698 PMCID: PMC4550810 DOI: 10.1016/j.pediatrneurol.2015.04.006] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 03/24/2015] [Accepted: 04/12/2015] [Indexed: 10/23/2022]
Abstract
Preterm neonates are surviving with a milder spectrum of motor and cognitive disabilities that appear to be related to widespread disturbances in cell maturation that target cerebral gray and white matter. Whereas the preterm brain was previously at high risk for destructive lesions, preterm survivors now commonly display less severe injury that is associated with aberrant regeneration and repair responses that result in reduced cerebral growth. Impaired cerebral white matter growth is related to myelination disturbances that are initiated by acute death of premyelinating oligodendrocytes, but are followed by rapid regeneration of premyelinating oligodendrocytes that fail to normally mature to myelinating cells. Although immature neurons are more resistant to cell death than mature neurons, they display widespread disturbances in maturation of their dendritic arbors and synapses, which further contributes to impaired cerebral growth. Thus, even more mild cerebral injury involves disrupted repair mechanisms in which neurons and premyelinating oligodendrocytes fail to fully mature during a critical window in development of neural circuitry. These recently recognized distinct forms of cerebral gray and white matter dysmaturation raise new diagnostic challenges and suggest new therapeutic strategies to promote brain growth and repair.
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Affiliation(s)
- Stephen A. Back
- Departments of Pediatrics and Neurology, Oregon Health & Science University, Portland, Oregon, U.S.A
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16
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Lee I, Neil JJ, Huettner PC, Smyser CD, Rogers CE, Shimony JS, Kidokoro H, Mysorekar IU, Inder TE. The impact of prenatal and neonatal infection on neurodevelopmental outcomes in very preterm infants. J Perinatol 2014; 34:741-7. [PMID: 25033076 PMCID: PMC4180799 DOI: 10.1038/jp.2014.79] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 02/15/2014] [Accepted: 02/24/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Determine the association of prenatal and neonatal infections with neurodevelopmental outcomes in very preterm infants. STUDY DESIGN Secondary retrospective analysis of 155 very preterm infants at a single tertiary referral center. General linear or logistic regression models were used to evaluate the association with hospital factors; brain injury, growth and development; and neurobehavioral outcome. RESULT Necrotizing enterocolitis with sepsis was associated with reduced transcerebellar diameter (38.3 vs 48.4 mm, P<0.001) and increased left ventricular diameter (12.0 vs 8.0 mm, P=0.005). Sepsis alone was associated with higher diffusivity in the left frontal lobe (1.85 vs 1.68 × 10⁻³ mm² s⁻¹, P=0.001) and right cingulum bundle (1.52 vs 1.45 × 10⁻³ mm 253 s⁻¹, P=0.002). Neurobehavioral outcomes were worse in children exposed to maternal genitourinary infection (cognitive composite: β=-8.8, P=0.001; receptive language score: β=-2.7, P<0.001; language composite: β=-14.9, P<0.001) or histological chorioamnionitis (language composite: β=-8.6, P=0.006), but not neonatal infection. CONCLUSION Neonatal infection was associated with changes in brain structure but not with neurobehavioral outcomes, whereas the opposite pattern was observed for maternal genitourinary tract infection. These findings emphasize the potential importance of infections during pregnancy on the neurodevelopmental outcomes of preterm infants.
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Affiliation(s)
- Iris Lee
- Department of Pediatrics, Washington University in St. Louis, St. Louis, USA
| | - Jeffrey J. Neil
- Department of Pediatrics, Washington University in St. Louis, St. Louis, USA,Department of Neurology, Washington University in St. Louis, St. Louis, USA,Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, USA
| | - Phyllis C. Huettner
- Department of Pathology and Immunology, Washington University in St. Louis, St. Louis, USA
| | - Christopher D. Smyser
- Department of Pediatrics, Washington University in St. Louis, St. Louis, USA,Department of Neurology, Washington University in St. Louis, St. Louis, USA
| | - Cynthia E. Rogers
- Department of Psychiatry, Washington University in St. Louis, St. Louis, USA
| | - Joshua S. Shimony
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, USA
| | - Hiroyuki Kidokoro
- Department of Pediatrics, Washington University in St. Louis, St. Louis, USA
| | - Indira U. Mysorekar
- Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, USA
| | - Terrie E. Inder
- Department of Pediatrics, Washington University in St. Louis, St. Louis, USA,Department of Neurology, Washington University in St. Louis, St. Louis, USA,Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, USA
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Stålnacke J, Lundequist A, Böhm B, Forssberg H, Smedler AC. Individual cognitive patterns and developmental trajectories after preterm birth. Child Neuropsychol 2014; 21:648-67. [PMID: 25265400 DOI: 10.1080/09297049.2014.958071] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Cognitive outcome after preterm birth is heterogeneous, and group level analyses may disguise individual variability in development. Using a person-oriented approach, this study investigated individual cognitive patterns and developmental trajectories from preschool age to late adolescence. As part of a prospective longitudinal study, 118 adolescents born preterm, with a birth weight < 1,500 g, participated in neuropsychological assessments at age 5½ years and at 18 years. At each age, four cognitive indices, two tapping general ability and two tapping executive functions, were formed to reflect each individual's cognitive profile. Cluster analyses were performed at each age separately, and individual movements between clusters across time were investigated. At both 5½ and 18 years, six distinct, and similar, cognitive patterns were identified. Executive functions were a weakness for some but not all subgroups, and verbal ability was a strength primarily among those whose overall performance fell within the normal range. Overall, cognitive ability at 5½ years was highly predictive of ability at age 18. Those who performed at low levels at 5½ years did not catch up but rather deteriorated in relative performance. Over half of the individuals who performed above the norm at 5½ years improved their relative performance by age 18. Among those performing around the norm at 5½ years, half improved their relative performance over time, whereas the other half faced increased problems, indicating a need for further developmental monitoring. Perinatal factors were not conclusively related to outcome, stressing the need for cognitive follow-up assessment of the preterm-born child before school entry.
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18
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Baron IS, Hopp C, Weiss BA. Developmental normative data for the Baron-Hopkins Board test of spatial location memory. Child Neuropsychol 2014; 21:732-50. [DOI: 10.1080/09297049.2014.957264] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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19
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Williamson KE, Jakobson LS, Saunders DR, Troje NF. Local and global aspects of biological motion perception in children born at very low birth weight. Child Neuropsychol 2014; 21:603-28. [PMID: 25103588 PMCID: PMC4566871 DOI: 10.1080/09297049.2014.945407] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 07/11/2014] [Indexed: 12/03/2022]
Abstract
Biological motion perception can be assessed using a variety of tasks. In the present study, 8- to 11-year-old children born prematurely at very low birth weight (<1500 g) and matched, full-term controls completed tasks that required the extraction of local motion cues, the ability to perceptually group these cues to extract information about body structure, and the ability to carry out higher order processes required for action recognition and person identification. Preterm children exhibited difficulties in all 4 aspects of biological motion perception. However, intercorrelations between test scores were weak in both full-term and preterm children--a finding that supports the view that these processes are relatively independent. Preterm children also displayed more autistic-like traits than full-term peers. In preterm (but not full-term) children, these traits were negatively correlated with performance in the task requiring structure-from-motion processing, r(30) = -.36, p < .05), but positively correlated with the ability to extract identity, r(30) = .45, p < .05). These findings extend previous reports of vulnerability in systems involved in processing dynamic cues in preterm children and suggest that a core deficit in social perception/cognition may contribute to the development of the social and behavioral difficulties even in members of this population who are functioning within the normal range intellectually. The results could inform the development of screening, diagnostic, and intervention tools.
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Affiliation(s)
- K. E. Williamson
- Department of Psychology, University of Manitoba, WinnipegMB, Canada
| | - L. S. Jakobson
- Department of Psychology, University of Manitoba, WinnipegMB, Canada
| | - D. R. Saunders
- Department of Psychology, Queen’s University, KingstonON, Canada
| | - N. F. Troje
- Department of Psychology, Queen’s University, KingstonON, Canada
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20
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Abstract
Considerable research has investigated the consequences of being born very preterm (VP; <32 weeks of gestation), especially in relation to cognitive functioning. While numerous cognitive and neuropsychological outcome studies have been published, it is important to consider methodological issues when reviewing this research, as the generalizability of the studies varies greatly. This article describes the nature of cognitive difficulties confronting VP children, both in terms of the frequency and severity of deficits. The breadth of cognitive difficulties reported in this population implies a generalized cognitive impairment; however, the presence of selective or primary cognitive deficits is discussed. It is concluded that whereas mortality and neonatal morbidity rates have decreased significantly in VP infants in recent decades, these children continue to be at significant risk for cognitive impairments and need to be closely monitored throughout childhood.
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Affiliation(s)
- Peter J Anderson
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia.
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21
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Back SA, Miller SP. Brain injury in premature neonates: A primary cerebral dysmaturation disorder? Ann Neurol 2014; 75:469-86. [PMID: 24615937 PMCID: PMC5989572 DOI: 10.1002/ana.24132] [Citation(s) in RCA: 238] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 03/04/2014] [Accepted: 03/05/2014] [Indexed: 12/11/2022]
Abstract
With advances in neonatal care, preterm neonates are surviving with an evolving constellation of motor and cognitive disabilities that appear to be related to widespread cellular maturational disturbances that target cerebral gray and white matter. Whereas preterm infants were previously at high risk for destructive brain lesions that resulted in cystic white matter injury and secondary cortical and subcortical gray matter degeneration, contemporary cohorts of preterm survivors commonly display less severe injury that does not appear to involve pronounced glial or neuronal loss. Nevertheless, these milder forms of injury are also associated with reduced cerebral growth. Recent human and experimental studies support that impaired cerebral growth is related to disparate responses in gray and white matter. Myelination disturbances in cerebral white matter are related to aberrant regeneration and repair responses to acute death of premyelinating late oligodendrocyte progenitors (preOLs). In response to preOL death, early oligodendrocyte progenitors rapidly proliferate and differentiate, but the regenerated preOLs fail to normally mature to myelinating cells required for white matter growth. Although immature neurons appear to be more resistant to cell death from hypoxia-ischemia than glia, they display widespread disturbances in maturation of their dendritic arbors, which further contribute to impaired cerebral growth. These complex and disparate responses of neurons and preOLs thus result in large numbers of cells that fail to fully mature during a critical window in development of neural circuitry. These recently recognized forms of cerebral gray and white matter dysmaturation raise new diagnostic challenges and suggest new therapeutic directions centered on reversal of the processes that promote dysmaturation.
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Affiliation(s)
- Stephen A Back
- Departments of Pediatrics, Oregon Health and Science University, Portland; Departments of Neurology, Oregon Health and Science University, Portland
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22
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Maitra K, Park HY, Eggenberger J, Matthiessen A, Knight E, Ng B. Difficulty in Mental, Neuromusculoskeletal, and Movement-Related School Functions Associated With Low Birthweight or Preterm Birth: A Meta-Analysis. Am J Occup Ther 2014; 68:140-8. [DOI: 10.5014/ajot.2014.009985] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
OBJECTIVE. Our objective was to perform a meta-analysis to investigate whether low birthweight (LBW) or preterm birth was associated with difficulty in mental, neuromusculoskeletal, and movement-related school function tasks.
METHOD. Two search strategies produced 40 studies that met the inclusion criteria for the meta-analysis and yielded 549 effect sizes (d). Heterogeneity was evaluated by obtaining Q and I-squared values. Egger’s regression intercept test and a funnel plot were used to check for publication bias.
RESULTS. Children born LBW exhibited considerable difficulties in mental (d = −0.655, p < .0001) and neuromusculoskeletal and movement-related tasks (d = −0.391, p < .0001) compared with children of normal birthweight. Children born preterm also exhibited significant difficulties compared with full-term children in mental, neuromusculoskeletal, and movement-related tasks (d = −0.237, p < .0001).
CONCLUSION. Deficits in mental and motor functions in children born LBW or preterm appear to have significant effects on school readiness and academic achievement.
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Affiliation(s)
- Kinsuk Maitra
- Kinsuk Maitra, PhD, OTR/L, is Chair and Professor, Department of Occupational Therapy, College of Nursing and Health Sciences, Florida International University, 11200 SW Eighth Street, MMC, AHC3 443, Miami, FL 33199;
| | - Hae Yean Park
- Hae Yean Park, PhD, OT, is Postdoctoral Fellow, Department of Occupational Therapy, Florida International University, Miami
| | - Jaime Eggenberger
- Jaime Eggenberger, Erin Knight, and Betty Ng are Students, Department of Occupational Therapy, Florida International University, Miami
| | - Angela Matthiessen
- Jaime Eggenberger, Erin Knight, and Betty Ng are Students, Department of Occupational Therapy, Florida International University, Miami
| | - Erin Knight
- Jaime Eggenberger, Erin Knight, and Betty Ng are Students, Department of Occupational Therapy, Florida International University, Miami
| | - Betty Ng
- Angela Matthiessen, MSOT, OTR/L, is Director, CreatAbility, Inc., Atlanta, GA
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23
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Back SA. Cerebral white and gray matter injury in newborns: new insights into pathophysiology and management. Clin Perinatol 2014; 41:1-24. [PMID: 24524444 PMCID: PMC3947650 DOI: 10.1016/j.clp.2013.11.001] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Increasing numbers of preterm neonates survive with motor and cognitive disabilities related to less destructive forms of cerebral injury that still result in reduced cerebral growth. White matter injury results in myelination disturbances related to aberrant responses to death of pre-myelinating oligodendrocytes (preOLs). PreOLs are rapidly regenerated but fail to mature to myelinating cells. Although immature projection neurons are more resistant to hypoxia-ischemia than preOLs, they display widespread disturbances in dendritic arbor maturation, which provides an explanation for impaired cerebral growth. Thus, large numbers of cells fail to fully mature during a critical window in development of neural circuitry. These recently recognized forms of cerebral gray and white matter dysmaturation suggest new therapeutic directions centered on reversal of the processes that promote dysmaturation.
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Affiliation(s)
- Stephen A. Back
- Professor of Pediatrics and Neurology Oregon Health & Science University Clyde and Elda Munson Professor of Pediatric Research Director, Neuroscience Section, Pape' Family Pediatric Research Institute
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24
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Molloy CS, Wilson-Ching M, Doyle LW, Anderson VA, Anderson PJ. Visual Memory and Learning in Extremely Low-Birth-Weight/Extremely Preterm Adolescents Compared With Controls: A Geographic Study. J Pediatr Psychol 2013; 39:316-31. [DOI: 10.1093/jpepsy/jst088] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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25
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Chau V, Synnes A, Grunau RE, Poskitt KJ, Brant R, Miller SP. Abnormal brain maturation in preterm neonates associated with adverse developmental outcomes. Neurology 2013; 81:2082-9. [PMID: 24212394 DOI: 10.1212/01.wnl.0000437298.43688.b9] [Citation(s) in RCA: 159] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE Our objective was to determine the association of early brain maturation with neurodevelopmental outcome in premature neonates. METHODS Neonates born between 24 and 32 weeks' gestation (April 2006 to August 2010) were prospectively studied with MRI early in life and again at term-equivalent age. Using diffusion tensor imaging and magnetic resonance spectroscopic imaging, fractional anisotropy (FA) (microstructure) and N-acetylaspartate (NAA)/choline (metabolism) were measured from the basal nuclei, white matter tracts, and superior white matter. Brain maturation is characterized by increasing FA and NAA/choline from early in life to term-equivalent age. In premature neonates, systemic illness and critical care therapies have been linked to abnormalities of these measures. Of the 177 neonates in this cohort, 5 died and 157 (91% of survivors) were assessed at 18 months' corrected age (adjusted for prematurity) using the Bayley Scales of Infant and Toddler Development III motor, cognitive, and language composite scores (mean = 100, SD = 15). RESULTS Among these 157 infants, white matter injury was seen in 48 (30%). Severe white matter injury, in 10 neonates (6%), was associated with a decrease in motor (-18 points; p < 0.001) and cognitive (-8 points; p = 0.085) scores. With greater severity of adverse neurodevelopmental outcomes, slower increases in FA and NAA/choline were observed in the basal nuclei and brain white matter regions as neonates matured to term-equivalent age, independent of the presence of white matter injury. CONCLUSIONS In the preterm neonate, abnormal brain maturation evolves through the period of neonatal intensive care and is associated with adverse neurodevelopmental outcomes.
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Affiliation(s)
- Vann Chau
- From the Departments of Pediatrics (S.P.M.), Divisions of Neurology (V.C.) and Neonatology (A.S., R.E.G.), Radiology (K.J.P.), and Statistics (R.B.), BC Children's & Women's Hospitals and University of British Columbia, and the Child & Family Research Institute (V.C., A.S., R.E.G., K.J.P., R.B., S.P.M.), Vancouver; and Department of Pediatrics (S.P.M., V.C.), Neurology, the Hospital for Sick Children and University of Toronto, Canada
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26
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Burnett AC, Scratch SE, Anderson PJ. Executive function outcome in preterm adolescents. Early Hum Dev 2013; 89:215-20. [PMID: 23455604 DOI: 10.1016/j.earlhumdev.2013.01.013] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 01/29/2013] [Indexed: 12/27/2022]
Abstract
Preterm birth (PT) and low birthweight (LBW) are risk factors for cognitive, academic, and behavioral difficulties. Executive functioning, which is an umbrella term encompassing higher-order problem-solving and goal-oriented abilities, may help to understand these impairments. This review article examines executive functioning in PT and LBW children, with a specific focus on adolescence and the functional consequences of executive dysfunction in this age group. We have focused on adolescence as it is a critical period for brain, cognitive and social-emotional development, and a period of increased autonomy, independence and reliance on executive functioning. While more longitudinal research is required, there is evidence demonstrating that the PT/LBW population is at increased risk for impairments across all executive domains. Emerging evidence also suggests that executive dysfunction may partly explain poorer academic and social-emotional competence in PT/LBW adolescents. In conclusion, PT/LBW adolescents exhibit poorer executive functioning, and close surveillance is recommended for high-risk individuals.
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Affiliation(s)
- Alice Claudia Burnett
- Murdoch Childrens Research Institute, Royal Children's Hospital, Flemington Rd, Parkville, VIC 3052, Australia.
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27
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McCoy TE, Conrad AL, Richman LC, Nopoulos PC, Bell EF. Memory processes in learning disability subtypes of children born preterm. Child Neuropsychol 2012; 19:173-89. [PMID: 22375897 PMCID: PMC3968320 DOI: 10.1080/09297049.2011.648922] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The purpose of this study was to evaluate immediate auditory and visual memory processes in learning disability subtypes of 40 children born preterm. Three subgroups of children were examined: (a) primary language disability group (n = 13), (b) perceptual-motor disability group (n = 14), and (c) no learning disability diagnosis group without identified language or perceptual-motor learning disability (n = 13). Between-group comparisons indicate no significant differences in immediate auditory or visual memory performances between language and perceptual-motor learning disability groups. Within-group comparisons revealed that both learning disability groups performed significantly lower on a task of immediate memory when the mode of stimulus presentation and mode of response were visual.
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Affiliation(s)
- Thomasin E McCoy
- Department of Psychiatry, University of Iowa, Iowa City, IA 52242, USA.
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28
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Jongbloed-Pereboom M, Janssen AJWM, Steenbergen B, Nijhuis-van der Sanden MWG. Motor learning and working memory in children born preterm: a systematic review. Neurosci Biobehav Rev 2012; 36:1314-30. [PMID: 22353425 DOI: 10.1016/j.neubiorev.2012.02.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Revised: 12/23/2011] [Accepted: 02/06/2012] [Indexed: 11/28/2022]
Abstract
Children born preterm have a higher risk for developing motor, cognitive, and behavioral problems. Motor problems can occur in combination with working memory problems, and working memory is important for explicit learning of motor skills. The relation between motor learning and working memory has never been reviewed. The goal of this review was to provide an overview of motor learning, visual working memory and the role of working memory on motor learning in preterm children. A systematic review conducted in four databases identified 38 relevant articles, which were evaluated for methodological quality. Only 4 of 38 articles discussed motor learning in preterm children. Thirty-four studies reported on visual working memory; preterm birth affected performance on visual working memory tests. Information regarding motor learning and the role of working memory on the different components of motor learning was not available. Future research should address this issue. Insight in the relation between motor learning and visual working memory may contribute to the development of evidence based intervention programs for children born preterm.
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29
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Baron IS, Brandt J, Ahronovich MD, Baker R, Erickson K, Litman FR. Selective deficit in spatial location memory in extremely low birth weight children at age six: the PETIT study. Child Neuropsychol 2011; 18:299-311. [PMID: 21961936 DOI: 10.1080/09297049.2011.613815] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Spatial location memory has rarely been assessed in young children due to a scarcity of developmentally appropriate tests. This study sought to compare nonverbal learning and recall in children born extremely low birth weight (ELBW; <1000 g) and less than 33 gestational weeks (GW) with term-born children at early school age using a recently developed and adapted test. We administered a modification of the Hopkins Board to 210 children at age six; 84 born ELBW (35 born < 26 GW; 49 born 26-33 GW) and 126 term-born. Six measures were obtained: naming, trials-to-criterion, errors-to-criterion, delayed item recall, delayed location recall, and percent retention. After age correction, ELBW children had worse general cognition, item naming, delayed item recall, delayed location recall, and percent retention than term-born children. Delayed item recall and percent retention performances of ELBW children remained worse after correction for general cognition. ELBW groups (< 26 GW and 26-33 GW) groups performed worse than term-born children in naming and delayed item recall with chronological age as covariate. Those born before 26 GW, but not 26-33 GW, performed worse than term-born children in delayed location recall and percent retention. Differences remained significant after controlling for gender, maternal education, and delivery type. All three groups' performance declined from final learning trial to delayed location recall, with a decline greater for less than 26 GW than term-born children. Extreme prematurity (< 26 GW) and ELBW are significant risk factors for spatial location memory deficit. The modified Hopkins Board discriminated high-risk preterm and term-born children at early school age and appears to be a useful test to measure this rarely studied cognitive capacity.
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Affiliation(s)
- Ida Sue Baron
- a Fairfax Neonatal Associates at Inova Fairfax Hospital for Children , Falls Church , Virginia , USA
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30
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Rose SA, Feldman JF, Jankowski JJ, Van Rossem R. Basic Information Processing Abilities at 11 years Account for Deficits in IQ Associated with Preterm Birth. INTELLIGENCE 2011; 39:198-209. [PMID: 21643482 PMCID: PMC3106278 DOI: 10.1016/j.intell.2011.03.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Although it is well established that preterms as a group do poorly relative to their full-term peers on tests of global cognitive functioning, the basis for this relative deficiency is less understood. The present paper examines preterm deficits in core cognitive abilities and determines their role in mediating preterm/full-term differences in IQ. The performance of 11-year-old children born preterm (birth weight <1750g) and their full-term controls were compared on a large battery of 15 tasks, covering four basic cognitive domains -- memory, attention, speed of processing and representational competence. The validity of these four domains was established using latent variables and confirmatory factor analysis (CFA). Preterms showed pervasive deficits within and across domains. Additionally, preterm deficits in IQ were completely mediated by these four cognitive domains in a structural equation model involving a cascade from elementary abilities (attention and speed), to more complex abilities (memory and representational competence), to IQ. The similarity of findings to those obtained with this cohort in infancy and toddlerhood suggest that preterm deficits persist - across time, across task, and from the non-verbal to the verbal period.
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Affiliation(s)
- Susan A. Rose
- Department of Pediatrics, Kennedy Center, Albert Einstein College of Medicine/Children’s Hospital at Montefiore, United States
| | - Judith F. Feldman
- Department of Pediatrics, Kennedy Center, Albert Einstein College of Medicine/Children’s Hospital at Montefiore, United States
| | - Jeffery J. Jankowski
- Department of Pediatrics, Kennedy Center, Albert Einstein College of Medicine/Children’s Hospital at Montefiore, United States
- Department of Social Sciences, Queensborough Community College/CUNY, United States
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31
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Anderson PJ, De Luca CR, Hutchinson E, Spencer-Smith MM, Roberts G, Doyle LW. Attention problems in a representative sample of extremely preterm/extremely low birth weight children. Dev Neuropsychol 2011; 36:57-73. [PMID: 21253991 DOI: 10.1080/87565641.2011.540538] [Citation(s) in RCA: 129] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The aim of this study was to examine attention in a large, representative, contemporary cohort of children born extremely preterm (EP) and/or extremely low birth weight (ELBW). Participants included 189 of 201 surviving children born EP (<28 weeks' gestation) or ELBW (<1,000 g) in 1997 in the state of Victoria, Australia. A comparison group of 173 of 199 children born full term and normal birth weight (FT/NBW) were randomly selected matching for birth hospital, expected due date, gender, mother's country of birth, and health insurance status. Participants were assessed at 8 years of age on subtests from the Test of Everyday Attention for Children (TEA-Ch) and the Wechsler Intelligence Scale for Children-4th Edition (WISC-IV). Measures of selective attention, sustained attention, attention encoding, and executive attention (inhibition, shifting attention, and divided attention) were administered. To assess behavioral elements of inattention, the primary caregiver completed the Behavior Rating Inventory of Executive Function (BRIEF) and the Conners' ADHD/DSM-IV Scale (CADS-P). The EP/ELBW group performed more poorly across all cognitive and behavioral measures than the FT/NBW group, with the exception of inhibition. The EP/ELBW group also had significantly elevated rates of impairment in selective, sustained, shifting and divided attention, as well as attention deficit hyperactivity disorder (ADHD) symptoms. No significant gender or gradient effects (e.g., <26 weeks' gestation vs. ≥ 26 weeks' gestation) were identified. Neonatal medical factors were not strong predictors of attention, although necrotizing enterocolitis (NEC) and cystic periventricular leukomalacia (PVL) were independent predictors of selective attention. In conclusion, our comprehensive assessment of attention provides strong evidence that children born EP/ELBW are at increased risk for attentional impairments, and as such, this population should be monitored closely during early and middle childhood with a focus on attention functioning.
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Affiliation(s)
- Peter J Anderson
- Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia.
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32
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Luu TM, Ment L, Allan W, Schneider K, Vohr BR. Executive and memory function in adolescents born very preterm. Pediatrics 2011; 127:e639-46. [PMID: 21300680 PMCID: PMC3065148 DOI: 10.1542/peds.2010-1421] [Citation(s) in RCA: 130] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Many preterm children display school difficulties, which may be mediated by impairment in executive function and memory. OBJECTIVE To evaluate executive and memory function among adolescents born preterm compared with term controls at 16 years. METHODS A total of 337 of 437 (77%) adolescents born in 1989 to 1992 with a birth weight < 1250 g and 102 term controls were assessed with a battery of executive function and memory tasks. Multiple regression analyses were used to compare groups and to identify associations between selected factors and outcomes among preterm subjects. RESULTS Adolescents born preterm, compared with term controls, showed deficits in executive function in the order of 0.4 to 0.6 SD on tasks of verbal fluency, inhibition, cognitive flexibility, planning/organization, and working memory as well as verbal and visuospatial memory. After exclusion of adolescents with neurosensory disabilities and full-scale IQ < 70, significant group differences persisted on most tests. Preterm subjects, compared with term controls, were at increased risk of exhibiting problems related to executive dysfunction, as measured with the Behavior Rating Inventory of Executive Function, on the Metacognition Index (odds ratio [OR]: 2.5 [95% confidence interval (CI): 1.2-5.1]) and the Global Executive Composite (OR: 4.2 [95% CI: 1.6-10.9]), but not on the Behavioral Regulation index (OR: 1.5 [95% CI: 0.7-3.5]). Among adolescents born preterm, severe brain injury on neonatal ultrasound and lower maternal education were the most consistent factors associated with poor outcomes. CONCLUSIONS Even after exclusion of preterm subjects with significant disabilities, adolescents born preterm in the early 1990s were at increased risk of deficits in executive function and memory.
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Affiliation(s)
- Thuy Mai Luu
- Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, 3175 Chemin Côte-Sainte-Catherine, Montréal, Canada H3T 1C5.
| | - Laura Ment
- Departments of Pediatrics and ,Neurology, Yale University School of Medicine, New Haven, Connecticut
| | - Walter Allan
- Department of Pediatrics, Maine Medical Center, Portland, Maine; and
| | | | - Betty R. Vohr
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island
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33
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Anderson PJ, Dewey D. Introduction: The Consequences of Being Born Very Early or Very Small. Dev Neuropsychol 2011; 36:1-4. [DOI: 10.1080/87565641.2011.540522] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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34
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Clark CAC, Woodward LJ. Neonatal Cerebral Abnormalities and Later Verbal and Visuospatial Working Memory Abilities of Children Born Very Preterm. Dev Neuropsychol 2010; 35:622-42. [PMID: 21038157 DOI: 10.1080/87565641.2010.508669] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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35
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Mulder H, Pitchford NJ, Hagger MS, Marlow N. Development of executive function and attention in preterm children: a systematic review. Dev Neuropsychol 2010; 34:393-421. [PMID: 20183707 DOI: 10.1080/87565640902964524] [Citation(s) in RCA: 254] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
We report on a systematic review of studies of executive function and attention in preterm children. Using meta-analysis, we confirm this is an area of weakness for preterm children, and show that the extent of difficulties is influenced by gestational age (GA), age at test, and skill under investigation. Effect size for selective and sustained attention and inhibition is related to GA. For studies with mean GA > or = 26 weeks, selective attention skills catch up with age, phonemic fluency skills are increasingly delayed, and ongoing deviance is shown for shifting skills (when assessed with specific measures). Implications for research and practice are discussed.
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Affiliation(s)
- Hanna Mulder
- School of Clinical Sciences, Academic Division of Human Development, University of Nottingham, Nottingham, U.K.
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36
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Aarnoudse-Moens CSH, Smidts DP, Oosterlaan J, Duivenvoorden HJ, Weisglas-Kuperus N. Executive function in very preterm children at early school age. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2009; 37:981-93. [PMID: 19488851 PMCID: PMC2734253 DOI: 10.1007/s10802-009-9327-z] [Citation(s) in RCA: 148] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We examined whether very preterm (< or =30 weeks gestation) children at early school age have impairments in executive function (EF) independent of IQ and processing speed, and whether demographic and neonatal risk factors were associated with EF impairments. A consecutive sample of 50 children (27 boys and 23 girls) born very preterm (mean age = 5.9 years, SD = 0.4, mean gestational age = 28.0 weeks, SD = 1.4) was compared to a sample of 50 age-matched full-term controls (23 girls and 27 boys, mean age = 6.0 years, SD = 0.6) with respect to performance on a comprehensive EF battery, assessing the domains of inhibition, working memory, switching, verbal fluency, and concept generation. The very preterm group demonstrated poor performance compared to the controls on all EF domains, even after partialing out the effects of IQ. Processing speed was marginally related to EF. Analyses with demographic and neonatal risk factors showed maternal education and gestational age to be related to EF. This study adds to the emerging body of literature showing that very preterm birth is associated with EF impairments.
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Affiliation(s)
- Cornelieke S H Aarnoudse-Moens
- Department of Pediatrics, Division of Neonatology, Erasmus University Medical Centre Sophia Children's Hospital Rotterdam, Rotterdam, The Netherlands.
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37
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Narberhaus A, Lawrence E, Allin MP, Walshe M, McGuire P, Rifkin L, Murray R, Nosarti C. Neural substrates of visual paired associates in young adults with a history of very preterm birth: Alterations in fronto-parieto-occipital networks and caudate nucleus. Neuroimage 2009; 47:1884-93. [PMID: 19376244 DOI: 10.1016/j.neuroimage.2009.04.036] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2008] [Revised: 04/01/2009] [Accepted: 04/08/2009] [Indexed: 11/18/2022] Open
Affiliation(s)
- Ana Narberhaus
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
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38
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Patterns of cerebral white matter damage and cognitive impairment in adolescents born very preterm. Int J Dev Neurosci 2008; 26:647-54. [PMID: 18765280 DOI: 10.1016/j.ijdevneu.2008.08.001] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2008] [Revised: 08/05/2008] [Accepted: 08/06/2008] [Indexed: 11/23/2022] Open
Abstract
There is increasing evidence about the presence of white matter damage in subjects with a history of premature birth, even in those classified as good outcome because of an apparently normal development. Although intellectual performance is within normal limits in premature children it is significantly decreased compared to paired controls. The purpose of this study was to investigate the relationship between a lower performance intelligence quotient and white matter damage in preterm adolescents. The sample comprised 44 adolescents (mean age+/-S.D.: 14.4+/-1.6 years) born before 32 weeks of gestational age and 43 term-born adolescents (14.5+/-2.1 years). Individual voxel-based morphometry analyses demonstrated that 35/44 (80%) preterm subjects had white matter abnormalities. The centrum semiovale and the posterior periventricular regions were the most frequently affected areas. Correlation analysis showed that in preterms the performance intelligence quotient correlated with the whole-brain white matter volume (r=0.32; P=0.036) but not with grey matter volume. Complementary analysis showed that low scores in the Digit Symbol subtest, a measure of processing speed, in the preterm group correlated with reductions in white matter concentration. These results suggest that white matter damage is highly common and that it persists until adolescence. Hence, diffuse white matter loss may be responsible for performance intelligence quotient and processing speed decrements in subjects with very preterm birth.
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39
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Saavalainen PM, Luoma L, Laukkanen E, M Bowler D, Määttä S, Kiviniemi V, Herrgård E. School performance of adolescents born preterm: neuropsychological and background correlates. Eur J Paediatr Neurol 2008; 12:246-52. [PMID: 17933569 DOI: 10.1016/j.ejpn.2007.08.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2006] [Revised: 03/22/2007] [Accepted: 08/21/2007] [Indexed: 10/22/2022]
Abstract
In this longitudinal study the development of preterm and control children was followed from infancy until adolescence. School performance at the age of 16 in subjects born very preterm with a gestational age (GA) of <or= 32 weeks was compared with the performance of adolescents born full-term. None of the subjects had major disabilities. The study groups performed similarly in most school subjects, including mathematics, the second foreign language and the native language (Finnish). Subjects in the preterm group achieved significantly higher grade points in the first foreign language than control subjects. In particular, the difference was evident between the preterm and control boys. The extremely preterm group with a GA <or= 29 weeks did not differ from the more mature group with a GA between 30 and 32 weeks in terms of the school grade points. Verbal and performance scale IQs as assessed at the age of 9 were of primary importance in predicting school success in adolescence. The results suggest a good outcome, measured by school grade scores at 16 years of age, of the subjects born very preterm.
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Affiliation(s)
- Pia M Saavalainen
- Department of Psychology, University of Joensuu, PO Box 111, 80101 Joensuu, Finland.
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